Abstract
A prospective study was performed on 80 cases of different types of sellar lesions
during the period between January 2007 and December 2010. The binasal approach was
used in all patients. Functioning lesions were diagnosed in 59 patients. The most
common secretory tumors were prolactinomas (37 patients) followed by adrenocorticotropic
hormone producing tumors (11 patients) and growth hormone producing tumors (11 patients).
Nonfunctioning lesions included: 14 pituitary adenomas, 2 chordomas, 2 metastatic
lesions (ovarian carcinoma and thyroid carcinoma), and 1 case of sarcoidosis, Rathke's
cleft cyst, and craniopharyngioma. Seven nonfunctioning cases developed apoplexy.
Among the 59 patients with functioning pituitary lesions, postoperative endocrinological
control was achieved in 51 of them (86.5%) 3 months postoperatively with normalization
of pituitary functions and complete tumor resection as proved by postoperative magnetic
resonance imaging. Postoperative visual field defect improvement was achieved in 15
out of 23 patients (65.2%), including the cases with apoplexy, with complete tumor
resection. Postoperative discomfort such as headache, vomiting, or dizziness was minimal
and hospitalization period was 2 to 3 days. Postoperative leak continued in one patient
in whom revision surgical repair was performed 7 days later. The merits, outcome,
and limitations of the approach were discussed.
Keywords
pituitary - sella - binasal - endoscopic approach
